Distributional Effects of Recent Health Insurance Expansions on Weight-Related Outcomes

Abstract

We provide new evidence that weight-related outcomes improved for the severely obese following three recent health insurance expansions. Using Behavioral Risk Factor Surveillance System (BRFSS) data from 2001 through 2016, we examine the effects of Massachusetts health care reform, the Affordable Care Act (ACA) dependent coverage mandate, and the ACA Medicaid expansion on Body Mass Index (BMI) and the likelihood of obesity or severe obesity. Estimates from unconditional quantile regression show that Body Mass Index (BMI) fell among the severely obese who are at the top of the distribution of BMI following all three of these insurance expansions. We also observe a robust reduction in the likelihood of severe obesity following the ACA dependent coverage mandate, and suggestive evidence of a reduction in severe obesity following Massachusetts health care reform. Together, these results identify an important benefit arising from recent health insurance expansions - improved weight-related outcomes for those with severe obesity.